The Unspeakable Odyssey of the Motionless Boy

How much of our humanity are we prepared to cede to machines? This is a dilemma of the future, but it's not much of a concern for Erik Ramsey. Erik can't move. He can't blink his eyes. And he hasn't said a word since 1999. But now, thanks to an electrode that was surgically implanted in his brain and linked to a computer, his nine-year silence is about to end.

At about nine o'clock in the evening on November 5, 1999, Erik Ramsey punched out of his after-school job at Arby's and went to see The Sixth Sense with a friend. They were driving home on a two-lane highway in Duluth, Georgia, a suburb about twenty-five miles northeast of Atlanta, when a minivan tried to make a U-turn from the oncoming lane. Erik's friend was speeding, and they never saw the other vehicle's headlights. The collision sent the minivan's engine flying out of its chassis. The car Erik was in, a late-model Camaro, careened into a curb and flipped end over end before landing upside down in a grove of small pine trees. The driver escaped with a chunk of metal embedded in his skull. Firefighters had to use the Jaws of Life to extract Erik. He was sixteen.

When Erik's father, Eddie, arrived at the Gwinnett Medical Center, he found his son lying on a table in the emergency room, screaming and writhing in pain. His first thought was simply, This is bad. Real bad. Erik's leg was dangling at a right angle from his torso. His head was perforated like a pincushion with pine straw. His spleen had been lacerated, his diaphragm had ruptured, and his left lung had collapsed. He wasn't yet under anesthesia, so the doctor asked Eddie to help keep his son pinned to the table. Even as he gasped for air, Erik's six-foot, 180-pound frame managed to rip free from his father's grasp.

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For the next three weeks, Erik lay in the intensive-care unit, awake but unresponsive. Once his condition stabilized, a neurologist finally gave Eddie and his wife, Sandra, the diagnosis. A blood clot had formed in a part of their son's brain stem called the pons, causing a stroke right at the juncture where his body met his mind. Erik was suffering from an extremely rare and permanent condition known as locked-in syndrome. "Bottom line is that he has no control over any of his muscles," the doctor told them. "He'll never move and he'll never speak." Otherwise, the accident had spared virtually all of Erik's conscious and unconscious processing systems. His memory, his reason, and his emotions were all intact. He could see and hear and feel--and feel pain--but he would never again have any way of communicating. Eddie walked into Erik's hospital room and looked at his son. Erik's eyes were wide open. He stared straight back at his father.

The only muscles over which Erik still had any voluntary command were the ones that control the up-and-down movement of his eyes. Unlike Jean-Dominique Bauby, the locked-in author of The Diving Bell and the Butterfly, Erik couldn't blink. Even moving his eyes left and right was beyond his capability. However, very soon after the accident, a speech therapist discovered that there remained one peephole in the otherwise impenetrable wall that kept Erik sequestered in his cell of flesh and bones. Because he could still look up and down, he could still say yes and no. "Up for heaven, down for hell," the therapist told him.

"Erik, are you deaf?"

That was the first question Eddie asked him, because until then no one was sure. Erik looked down.

"So you must be tired of people yelling at you?"

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He looked up and opened his eyes emphatically. That was nine years ago.

The Office of Neural Signals, Inc,. is located in a single-story yellow clapboard building in a professional park in Duluth, only a few miles from the Ramseys' home. Three engraved patents hang on a wall near the door, including US 7275035 B2, "System and Method for Speech Generation from Brain Activity," granted September 25, 2007, to Dr. Philip Kennedy, a pioneer in the field of brain-computer interface (BCI) research. On the opposite wall there is a small poster that reads:

WHO BENEFITS?

TODAY: ALS, Brain Stem Stroke, Other Locked-In Patients

TOMORROW: Spinal Cord Injured, Cyborgs, Enhancement of

Normal Humans

In the largest room of the dark, cluttered office, tables are stacked with computer monitors and electronics equipment, and a web of cables drapes between dislodged ceiling tiles. In the center of the room, Erik Ramsey is sitting in his wheelchair, wearing a blue sweat suit and slippers, with a bundle of wires coming out the back of his head. He's staring at a wall onto which Kennedy has projected a matrix of six words: heat, hid, hat, hut, hoot, and hot. They represent each of the major English vowel sounds. Kennedy, tall and stately at sixty, asks Erik to think about making the sound uh-ee. As he does, a green cursor jitters across the wall from hut to heat, and a booming vibrato pours out of the speaker: "uuuhahuuuuhaheeeeeeee." The sound is coming straight from Erik's brain.

Kennedy is trying to help Erik become the first human being ever to have his thoughts translated directly into speech. In November 2004, Kennedy's team put Erik into an fMRI scanner and showed him images of animals. While the scanner monitored Erik's brain activity, Kennedy asked him to say the name of each animal in his head: "This is a lion. This is an elephant." The fMRI produced a map guiding them to the precise area of Erik's brain that was activated when he tried to speak, a region of the premotor cortex that controls movement of the mouth, lips, tongue, and jaw. A few weeks later, neurosurgeons working with Kennedy opened Erik's skull and threaded a tiny glass cone containing three long, hair-thin Teflon-coated gold wires into exactly that part of his brain.

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Within a few months, Kennedy had Erik producing short words like dada and mama, but the model he was using to interpret the brain signals was too simple ever to decipher real speech. When Kennedy further analyzed the signals, he discovered that he could detect thirty-two of thirty-nine English phonemes, or basic sound units, in the electrode's output. In 2006, Frank Guenther, a computational neuroscientist at Boston University, joined the project. An expert in the brain's speech systems, Guenther helped Kennedy develop a computer decoder that could turn those patterns into a prosthetic voice.

Elinor Carucci

"Now, Erik, we're going to play another sound for you," says Kennedy. He's sitting next to Erik, a hand on his forearm. "This time I want you to think about the sound uh-ih." The computer produces the noise that Erik is supposed to make, then there's a quick beep. Erik is now in control of the voice coming out of the speaker. He's sitting perfectly still, but the green cursor leaps from hut to hoot to hat to hit as he tries to steady the vibrating sound with his thoughts. The speaker beeps again.

"All right Erik, you almost got it that time," says Kennedy, whose subtle Irish accent hints at his Limerick childhood. "Let's try it again."

When Erik thinks about puckering his mouth into an o or stretching his lips into an e, a unique pattern of neurons fires--even though his body doesn't respond. It's like flicking switches that connect to a burned-out bulb. The electrode implant picks up the noisy firing signals of about fifty different neurons, amplifies them, and transmits them across Erik's skull to two small receivers glued to shaved spots on the crown of his head. Those receivers then feed the signal into a computer, which uses a sophisticated algorithm to compare the pattern of neural firings to a library of patterns Kennedy recorded earlier. It takes about fifty milliseconds for the computer to figure out what Erik is trying to say and translate those thoughts into sound.

This is the hardest work Erik does all week, and after three hours he's fading. Despite the dissolved Provigil capsule that he ingested through his feeding tube at the beginning of the session, his eyes are starting to close. Kennedy promises him that if he can do one more round of testing, he'll play the Headbangers Ball CD, one of Erik's favorites. This seems to reenergize him. He tries uh-ih again, and this time guides the cursor precisely from hut to hit. The deep Southern drawl that fills the room is actually a digitized sampling of Eddie's voice. (Kennedy and Guenther figured it was as close as they'd be able to get to Erik's own.) Nobody would ever mistake these simple vowel sounds for language, but they're just the first steps. This fall, a new decoder that Guenther is developing will allow Erik to form consonants as well. The goal: full sentences within five years.

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Locked-In Syndrome was only identified as a medical condition in the sixties. It can develop in two ways: either gradually, as the result of a degenerative disease like ALS, or suddenly, as the result of a stroke or trauma. No American organization keeps statistics about how many people are locked-in, but there are probably no more than several thousand patients each year in the United States who survive the kind of brain-stem stroke that crippled Erik. Almost 90 percent of them die within four months, though a few manage to hang on for years, even decades.

Hard as it is to call Erik lucky, he was fortunate that the doctors recognized his condition so quickly. There are stories of people being locked-in for years before anyone notices the fully conscious person hiding inside the paralyzed body. In 1966, a thirty-two-year-old woman named Julia Tavalaro became locked-in after a brain hemorrhage and was sent to Goldwater Memorial Hospital on Roosevelt Island, New York, where the staff took to calling her "the vegetable." It wasn't until six years later that a family member noticed Tavalaro trying to smile after she heard a dirty joke. She was immediately taught to communicate with eye blinks and became a poet and author. She died in 2003 at the age of sixty-eight, having never spoken for thirty-seven years.

After Erik's accident, he stayed in the hospital for more than a month. At first he had so many visitors that they couldn't all crowd into his hospital room at once. Eddie remembers one girl in particular with dyed-blue hair who cried and cried when she visited Erik, then never came back.

In the hospital, the doctors advised Eddie and Sandra that there was no way the family would be able to provide Erik with the 24/7 care he needed at home. They all suggested that the best thing they could do would be to put him in a good nursing home and visit often.

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That Thanksgiving, November 25, 1999, was the first without Erik. In fact, it was pretty much the first time in the three weeks since the accident that Eddie had been home for any longer than to shower or pick up fresh clothes. It was rainy that day, "dreary and miserable," Eddie recalls, and when he looked across the table at Erik's empty chair and down at his plate of instant mashed potatoes, he finally crumpled under the weight of everything he'd been trying to carry. "I just couldn't handle it anymore, and I hated that I wasn't strong for my family," he says. "Somehow, and I can't explain it, I gained strength from that event and that day. I realized I had to take control of what would be the future for our household." The family decided that even if it meant reorienting their entire lives around Erik's care, they weren't going to stick him in some nursing home.

While Erik was still in rehab, friends of the family pitched in to remodel the Ramseys' twelve-hundred-square-foot split-level house to accommodate Erik's wheelchair. They ripped out the flooring of the den, which was to become Erik's bedroom, and replaced it with linoleum tiles, knowing there'd be lots of mopping. They put a futon in the den for Erik's younger brother, Matthew, now a Kia mechanic, to sleep on. Someone would always have to be there in case anything were to happen in the middle of the night.

In time, the family settled into a schedule. Erik is fed four times a day through a feeding tube that empties directly into his stomach. Almost every meal for the last nine years has consisted of two cans of a soupy brown liquid called Compleat whose main ingredients are ground vegetables and chicken stock. Twice a week, he is given a rectal-suppository laxative to clean his bowels. He urinates through a catheter into a bag that has to be emptied every five to six hours. Twice a day, a vibrating black vest is wrapped around his chest to help clear lung congestion. Every hour, his muscles have to be stretched to prevent uncomfortable cramps, and twice a day he is put through an hour of range-of-motion exercises to keep his muscles from atrophying. Because Erik's tear ducts no longer function, someone has to remember to put saline drops in his eyes every ninety minutes, lest they begin to feel like sandpaper. And because he has no way of expressing pain or discomfort, all this care must be administered as gingerly as if he were a newborn. When Erik's fingernails have to be trimmed, Eddie uses his teeth.

When Kennedy began putting brain implants into lab animals in the mid-eighties, many of his colleagues were skeptical. "When I was starting out, it was very hard to persuade people that this would work," he says, sitting behind a desk in his small office at Neural Signals. "In the beginning, we couldn't get any funding." Nothing about the underlying technology Kennedy was using was new--neuroscientists had been wiretapping the brain since the fifties--but what he was proposing seemed just a little too simple to work. Nobody believed you could get enough useful data out of a single electrode to control even the simplest computer program, much less a prosthetic voice. "I presented at a major neuroscience conference, and nobody could see it except the students," he says.

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For all the advances that have been made in brain science in recent decades, scientists are still relatively clueless about what transpires in the neural circuitry of the human cortex, the wrinkled and remarkably homogeneous outer layer of the brain that allows us to plan for the future, do long division, write poetry, and--in Erik's case--speak through a computer. One of Kennedy's early insights was that you don't necessarily have to understand all the intricacies of the brain in order to communicate with it. Even though Kennedy has no way of knowing specifically which fifty neurons are being recorded by Erik's implant, he knows he's in the right region of the brain. All the implant has to do is gather enough signals; the pattern-recognition software takes care of the rest.

In 1986, while running a lab at Georgia Tech's Biomedical Engineering Center, Kennedy implanted his first rat, followed by a monkey six years later. Four years after that, in 1996, he became the first scientist to receive FDA approval to implant a BCI in a locked-in human. The subject, an ALS patient named Marjorie, died just seventy-six days after receiving her implant, but in that short period she learned to control a simple binary switch with her brain. It was enough for her to say yes and no, and sufficient proof of concept for Kennedy to move ahead with a second locked-in ALS patient named Johnnie Ray, who used his implant to control a mouse cursor and spell out short words. At one point Kennedy asked him what it felt like to operate a computer with his brain. He typed out, "NOTHING."

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After Johnnie Ray, the press began to notice Kennedy's work, and so did other scientists. In 2004, a company called Cyberkinetics, led by the Brown University neuroscientist John Donoghue, received the second (and only other) FDA approval to implant BCIs in human subjects. Donoghue's first patient, a twenty-four-year-old quadriplegic named Matthew Nagle, became so adept at steering a computer with his thoughts that he was able to draw circles on the screen and even play Pong. Miguel Nicolelis, at Duke, and John Chapin, at the State University of New York Downstate Medical Center, have trained monkeys to use an implant that controls a robotic arm. Just to show they could, they transmitted a monkey's brain signals over the Internet to a robotic arm six hundred miles away.

In December 1999, shortly after the discovery that Erik could still communicate with his eyes, Eddie printed up a chart with the letters of the alphabet on it, divided into five rows and six columns. The family would read through the chart until Erik indicated he'd found the letter he was looking for, by pushing his eyes upward. For the first time since the accident, he could express himself, however haltingly. One of the first questions he asked his mother was, "Why is it taking so long?"

Erik wasn't a particularly loquacious or introspective guy before the accident, and though it's impossible to imagine that his condition hasn't given him an entirely new perspective on life, he never made much of an attempt to express it with the letter chart. Most of the words he spelled out with his eyeballs were for the sake of naming movies he wanted to watch--Erik may be the world's single most prolific Netflix renter, averaging six to eight films a day--or CDs he wanted to listen to. Listening to music and watching movies are practically the only leisure pursuits he can enjoy on the same plane as the rest of us, although optical-nerve damage from the accident means he has to watch on a seventy-two-inch television. Still, he's often forced to sit through shows he'd rather skip. One evening, as he was sitting next to his mother watching 60 Minutes, he grabbed her attention with a guttural grunt, a sound he can make only with enormous effort. She brought over the letter board and he took several minutes to spell out a question: "Why do you watch such crappy shows?"

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Elinor Carucci

"That was classic Erik," says Sandra, a cheery woman of Philippine descent. She and I are sitting with Erik late one evening in May in the sunken den of their home. She's wearing a black pantsuit and a pink jacket with a cross pinned to her lapel. She pulls out a box of pictures from before the accident. There's Erik in front of Stone Mountain, a husky kid with an oversized T-shirt down to his knees. There he is shoving his little brother. There he is drinking a Coke at the 1996 Olympics. "Erik was very mild-mannered," she says, then catches herself. "He is very mild-mannered." He's sitting next to us, but we talk about him as if he weren't.

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Erik loves heavy metal, especially Slipknot and Ozzy Osbourne, and he used to love moshing. He skateboarded wherever he could, especially in places where skateboarding was prohibited. He'd often sneak out at night and come back early the next morning. His family called him the pied piper because of the way his younger cousins followed him around everywhere.

He used to tell people he wanted to be an animator when he grew up. He drew everywhere and on everything. In the first years after the accident, Sandra used to think everything might turn out all right if Erik could only get back the use of his drawing hand.

Erik seems absorbed in the film he's watching (Sydney White, the Amanda Bynes movie about a group of misfit coeds pledging a sorority), so Sandra and I move into the small kitchen overlooking the den, where we talk about him in hushed tones. "I think that he finally accepted that he has no control," Sandra tells me. "We used to ask him if it was okay if we watch this or that on the television and he would actually say no. He doesn't anymore. We used to ask if we could sleep in his bed and he would say no. Now he doesn't mind." She peers over the banister to check on Erik. "We may have denial problems," she says, almost whispering now. "If it were me, how would I feel? Would I feel it's a useless life, that I'd rather be dead? I've always been afraid to ask him that. I'm scared to hear the truth about what he feels. Maybe I'm scared to hear that he wants to leave."

I ask Sandra if she's hopeful.

"Honestly, I don't see it," she says. "But I do cling. I cling to the hope that he could be one of the exceptions--that as young as he is now, he might be able to make it to when this new research becomes successful. My main concern is what will happen when we get old. If we keep him healthy, he'll probably live as long as you and me. He could stay like this another forty years."

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Every so often, Erik drops a hint that his old self is still hiding inside his crippled body. When a pretty girl walks by, he'll look up at his father to see if he noticed. "I think he has a thing for Hispanic chicks," Eddie tells me one day as we sit at a picnic table in his backyard, amid the overgrown weeds he hasn't had time to tend, next to an outline of the deck he hasn't had time to build. Eddie works the 5:00 A.M. to 1:00 P.M. shift at the Athens post office, an hour away. When he gets home from work, he takes Erik on a daily walk around the local track. He knows his son loves to watch the girls jog. When the opportunity presents itself, Eddie will push Erik behind a woman with big breasts or an enormous butt. It never fails to make him laugh.

Laughing and crying, it turns out, are two things he can still do--although his dry tear ducts produce no drops. They're involuntary reactions, like jerking a finger off a hot surface, that originate in more primitive parts of the nervous system that the accident left untouched. When Erik laughs, there's no mistaking it. His body spasms and he emits a high-pitched shriek that sounds as if he's just been stabbed in the kidneys. For a while Erik had a Hispanic nurse who spoke barely a word of English. He would use the letter chart to send her in search of preposterously titled films. When she'd come back and tell him she couldn't find the movie he was looking for, he'd laugh uproariously.

During those first years after the accident, Erik could spell out sentences as fast as his human translators could keep up. But in 2004, he was struck with a bout of pneumonia that sent him back to the hospital for three weeks. When he got out, it was clear to everyone who knew him that he'd changed. He had become slower and even more withdrawn than before. And for some reason, he was no longer able to work the letter board. He'd spell out gobbledygook, or refuse to use it at all.

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"I don't know what part of him we lost then," his former special-education teacher, Vicki Conway, says. "What he was spelling no longer made any sense. But then again, he could have been bullshitting me. My sense, though, is he would have wanted to communicate if he could."

After the pneumonia, it became a whole lot harder to read Erik's eyes. The movements were more subtle. You often had to ask him a question twice to figure out whether he was saying yes or no. Eventually, his parents stopped bothering with the letter chart and put it away. Since then, Erik hasn't communicated a single word.

Elinor Carucci

It's a challenge to interview someone who can hear everything but can answer only yes or no. There are questions I want to ask Erik but that I'm afraid might be cruel. Do you feel your life is worth living? Do you ever contemplate suicide? If there were more to his responses than the motion of his eyeballs, I might be able to guess what he's feeling. I might not ask certain questions, or I might press harder. But even the most mundane questions are difficult to ask, because they've got to be phrased in a way that they can be answered with a binary response. My questions all have to begin with do; I wish they could begin with how.

"Do you remember the moment when you realized that you could no longer move or speak?"

He looks down again.

"Do you think about the future?"

His eyes open wide.

"Do you feel you've come to peace with what happened?"

He looks up.

"But you don't like it, do you?" Eddie adds.

He looks down.

"If I were in your situation, I'd be pissed, too," says Eddie.

Yes, Erik believes in God, but no, he doesn't pray. Yes, he feels that his days, on average, are getting better. Yes, he believes that he'll someday be able to express himself through the implant. Yes, he's constantly in pain. No, the rest of us can't imagine what it's like. Yes, he lies with his eyes often. No, he no longer spends much time thinking about what he could do if he could move. No, even in his dreams, he doesn't move. Yes, he does have in mind the first thing he'll say when he can finally speak again. Yes, he occasionally feels the need to scream. Yes, his friends let him down.

Most of Erik's high school pals dropped out of his life pretty quickly after the accident. "It wasn't that they didn't care," says Mike Wood, the only friend who still visits with any regularity. "It was just too tough." Especially for Erik's buddy Chris, the boy who was driving the Camaro. He used to come by from time to time, and then only on Erik's birthdays. Eventually he disappeared altogether.

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Erik's days are unimaginably lonely. Sometimes, for long stretches he will seem to disappear into another dimension. He sits there with his eyes open, his mind churning, but he's completely unresponsive to the world around him. Eddie says he often comes downstairs in the middle of the night to find Erik lying awake, staring at the ceiling. Erik told his mother once, back when he could still use the letter chart, that he transports himself to a different world. But he never spelled out what that world is like.

There's one question I dread asking--the question that hangs over everything: Would Erik rather be dead? Nobody has ever asked him, so nobody knows. I try to find the most delicate way to bring it up.

"Do you ever wish you hadn't survived the car crash?"

I can't tell which way his eyes move. Eddie is silent. He scratches his leg. I ask again. I look to Eddie. I look back at Erik. Eddie shakes his head. "He's saying, 'No.' "

On the wall near Kennedy's engraved patents there is another small poster that reads TOTAL BCI MARKET: 6,301,163,435 BRAINS IN THE WORLD. In other words, everyone. Cochlear implants, the first commercially successful brain-computer interfaces, have already allowed 100,000 deaf people to hear. Soon the blind will be able to see through cameras that transmit images straight to the visual cortex, and the paralyzed will control robotic limbs as if they were their own. All this is already being done with lab animals. But healing the sick is just the beginning of the BCI revolution that Kennedy and others in his field envision.

Imagine, Kennedy suggests, a "personal digital assistant in the brain." Or a digital surrogate memory that remembers everything. Or the entire contents of Google a single thought away. Or, more likely, some other application that would be impossible to anticipate today. But what does seem unstoppable is the expanding overlap between our minds and our machines.

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Once you start pondering what it would mean to merge brains and computers--to truly integrate our physical minds with our artificial ones--it can provoke some queasy thoughts about the location of the soul, the nature of consciousness, and what it means to be human. All of a sudden, what we think of as the mind starts to sound like something far more distributed, and far hazier than it's comfortable to contemplate. We tend to think of the self, our ineffable essence, as a starkly delimited entity. Even if modern cognitive neuroscience has rejected René Descartes's old idea of a homuncular soul that resides in the pineal gland and controls the human body, the fact is that most of us still believe there is a distinct "me" somewhere up there driving the bus. At the very least, most people would assume that their self could not possibly extend beyond the boundary of their body into a computer. But why should that necessarily be the case? Is it even the case today?

"Human beings are already natural-born cyborgs," says Andy Clark, a philosopher at the University of Edinburgh who writes about the metaphysical problems posed by BCIs. For as long as we've been humans, we've been intermingling our minds with technology. In fact, it's one of the most essentially human things we do. What are pen and paper if not cognitive prostheses? What was the invention of algebra if not a "mindware upgrade?" And what are books if not external repositories for the contents of our brains?

I'm typing this on a laptop, which is doing all sorts of thinking so that my own brain doesn't have to, and whose hard drive contains a trove of documents that are, in a very real way, an extension of my own memory. I've already got a brain-computer interface: my eyes and my fingers. Yes, it's primitive, and yes, it's noninvasive, but it's on the same evolutionary continuum as Kennedy's electrode implants. We're all, as Clark puts it, "cyborgs without surgery, symbionts without sutures."

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With Erik, though, it's quite a bit harder to pin down where the man ends and the machine begins. Consider how much fuzzier that line will become if BCIs can someday control not just prosthetic voices but entire prosthetic bodies--another one of the unsettling scenarios Kennedy foresees.

"I imagine it's possible that someday you'll have simply an isolated brain on a support system, functioning better than any human brain out there now," Kennedy tells me with a nervous chuckle. "It's kind of scary, but it's what's going to happen."

We'll see. But you don't have to be a reactionary, a fundamentalist, or a Luddite to wonder whether plugging minds into computers is ultimately such a terrific idea. Even Kennedy himself is ambivalent about where his research may someday lead. I ask him whether he'd ever want to have one of the brave new BCIs he's describing installed in his own head.

"I'm not sure I would," he says. "And I'm not sure I should be allowed to."

Not surprisingly, the military has taken a keen interest in all of this. While Kennedy gets his funding from the NIH, some of his peers in the BCI field are bankrolled by DARPA, the Defense Department's advanced-research wing, which hopes today's work with monkeys and quadriplegics will pay off in the future with fighter jets that respond instantaneously to pilots' thoughts and robotic marines safely controlled by brains on the other side of the world.

"If cloning is controversial today, the field of BCI will be just as controversial tomorrow," Kennedy predicts. Probably even more so. Today, bioethicists work up sweats over such hot-potato topics as genetic engineering and "cognitive steroids," but these kinds of enhancements are just tweaking the dials compared with what it would mean to fully marry computers and brains. A smarter, taller, stronger, disease-resistant person who lives to 150 is still, in the end, just a person. But if we could give someone a perfect memory, the processing power of a supercomputer, and a mind that taps directly into the entire collective knowledge of humanity, well, that's when we'd need to expand our vocabulary. What Kennedy is ultimately talking about is a final escape from the biology of being human.

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"It's around here somewhere, " says Eddie, searching the bookcase next to Erik's bed. The folded, laminated piece of paper he's looking for, about the size of a tabloid newspaper, turns up under a stack of towels.

"He hasn't used this thing in, what, four years?" I ask.

"Not much."

"Do you think he might be interested in trying it again?"

"We could always ask." He carries the board over to Erik and shows it to him. "Do you want to try to dictate? Do you remember how?"

Erik looks up. Back when he was using the chart all the time, he had it memorized, but that was so long ago that Eddie figures he better hold it in front of Erik's face. He settles into a chair next to him and glances at his wife, who has come over to hold Erik's hand. This could be the first time since 2004 that Erik communicates anything more than a yes or a no, but Eddie and Sandra seem surprisingly blasé about the exercise.

After a few false starts, Eddie coaxes the first letter out of Erik. It's the first letter on the fifth line.

"Are you sure it's an a, Erik?"

He looks up and coughs violently. Eddie has to put down the chart to squirt some water into Erik's throat and then suck out the phlegm with a dentist's vacuum hose.

Eddie keeps running through the board. The next letter is m. Then a. Then n. For some reason, Erik starts laughing.

"It's that funny and you've only spelled four letters?" asks Eddie. "This must be something really funny."

Next is a d. Eddie repeats the letters to himself: "A-M-A-N-D."

"Amanda?" His voice rises. "Is that what you're trying to say? Amanda?" He chuckles and slaps his knee. "You're spelling the name of a girl?" It does seem an improbably romantic first word to have been incubating all these years. Eddie gets excited and yells into the kitchen to Erik's brother. "Matt, who's Amanda? Was that one of the Playboy bunnies in that big picture he had?"

"I don't know," says Matt. Eddie asks him to get Mike Wood on the phone. Matt has him on speed dial. "Ask him if he knows any Amandas."

Matt comes back into the den. "Mike says he doesn't know any Amandas."

Eddie asks Erik again. "Who's Amanda? Is that the name of the blue-haired girl who visited you in the hospital?"

Erik's eyes don't move.

The doorbell rings. Eddie folds up the letter board. The pizza is here.

Later that week, I e-mail Eddie to ask him what he makes of Erik's attempt to spell. We had gone back after dinner and tried again, but we never got anything more than an f out of him. In the rush of trying to get everything into my notebook, I hadn't really processed what he might have been trying to say. But reviewing my notes now, I'm haunted by the possibility that we'd cut him off too soon. What if he'd been trying to say, "A man d . . ."? (The letter chart doesn't have a space bar.)

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Eddie writes back to say we should try the letter chart again. He also suggests that the next time we try to get Erik to spell, it might go faster if there's a pretty young woman at Erik's arm helping him. What he doesn't suggest, but what we both know might very well be the case, is that a-m-a-n-d might not mean anything at all.

When I return to Duluth three weeks later, in late May, we load Erik into the Ramseys' specially outfitted van and drive him over to the Neural Signals office, where Deanna Felice, a rising senior at Georgia Tech who works in Kennedy's

lab, has offered to help. She's wearing a blue dress and a pearl necklace. She keeps one hand on Erik's the entire time.

Kennedy lowers himself to eye level with Erik. "This is your big chance to say whatever you want to--how many people read Esquire?"

Deanna puts the chart in front of his face. "Is the first letter on line one, Erik?" Each letter takes about a minute to work out, and Erik's eye movements are now so subtle that Eddie has to be called in to interpret them.

T . . . O . . . F . . . M.

"Did we miss a letter in there?" I ask.

"Is there supposed to be an e in between the f and the m?" suggests Eddie.

He looks up.

N . . . I . . . T.

"Is that all correct?" Yes. "Do you want to stop?" No.

N . . . T . . . A . . . L.

"Erik, do you remember how to spell?"

Yes.

Kennedy writes the letters on a dry-erase board and props it up in front of Erik's wheelchair. ZZ Top is playing in the background.

"Erik, to me as a bystander, this doesn't make sense," says Eddie. "We've got to get it to the point where it makes sense. Is there supposed to be a w between the t and the o?"

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Yes.

"Is everything else right?"

Yes.

"I can't even begin to fathom how frustrating this must be," I tell Erik. Not for the first time, I have the uncomfortable inkling that we're trying to read a Ouija board and that this whole exercise is a charade for my benefit.

Despite the occasional blinked-out memoir, the inner lives of locked-in patients remain, basically, a mystery. Few have lived as long as Erik; fewer still have had the capacity to describe their experience. And so nobody can say just how much of Erik is still in there. Nine years is a very long time for a mind to be in total isolation. It's possible that his brain has done what his body cannot: slowly shut itself down.

A . . . G . . . O . . . C . . . O . . . K.

"Do you still have more to say?"

Yes.

Y . . . T . . . A . . . X . . . U.

"Erik, are you getting tired?"

Yes.

Kennedy points at the whiteboard and goes letter by letter asking him if each is correct, and then where the spaces should go. When he's done rearranging, the board reads: "TWO FEM N ITNA LA GO COKYT AXU." We all stare at it, trying to decipher the hieroglyphs, Erik's first sentence in years. Dr. Kennedy shakes his head. Eddie leaves the room to take a walk.

Who knows why Erik lost the ability to spell. It's just one of the many mysteries of his condition. But even while his linguistic abilities have backslid in one domain, they've been making substantial progress in another.

It's been six weeks since I first watched Erik do his speech exercises in Dr. Kennedy's lab, and in that short time he's become much more adept at making the computer obey his commands. Back in early April, he was having trouble producing a single vowel sound consistently. Now he's stringing together chains of two, even three vowels at a time, and he's making far fewer errors. Kennedy asks a research aide to reconfigure the software so Erik can roam around the "vowel space" with total freedom.

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"Try uh-ah," Kennedy says. The cursor jumps around the screen from hut to hat, and the deep computer voice echoes the trembling sound that Erik's brain is trying to produce.

Next he tries uh-oh and then uh-oo, and makes them both perfectly.

Kennedy puts his face right in front of Erik's. "You can really do it when you want to," he says ecstatically. "This time I want you to go from oe to oo and then up to ee." The hard ee sound is the vowel Erik has been having the most trouble with. To make it, he has to think about spreading the edges of his lips and stretching his cheeks. The part of the premotor cortex that controls the cheeks is right next to the region that controls the lips, tongue, and jaw, where Erik's implant sits, but Kennedy suspects the cheek neurons may still be too far away for the implant to catch their firing signals. Nevertheless, when Erik practices tying together an oe-oo-ee nine times in a row, he nails it on six, only failing on the other three tests because of a cough or a spasm. It's hardly speech, but Kennedy and Guenther are now on the verge of introducing their new computational model designed to allow Erik to produce consonants as well, and eventually real, meaningful sentences. But even with just vowels, there is a lot he should soon be able to say. In the 1950s, a Swedish linguist named Gunnar Fant demonstrated that you can string together the sorts of vowellike sounds that Erik can already make to form slurred but comprehensible speech.

Kennedy pulls up a program on his computer screen to show me. It's the same vowel map Erik has been navigating with his mind, only Kennedy can now control it with his mouse. As he loops his cursor around the screen, a sound comes out of the speaker: "Ow-uuuuuuh-oo. Ai-uuuuuh-oo." He makes it again, and this time I hear it: "How are you? I love you." And again:

"How are you? I love you."

"How are you? I love you."

"How are you? I love you."

Dr. Kennedy turns to Erik, who has been watching us the whole time. "I'd like him to be able to say that to his father."

Erik's body shivers in one of his regular, and painful, muscle spasms, and then sinks back into his wheelchair. The session is over, but Eddie hasn't yet returned from his walk. Kennedy plays some Ozzy Osbourne, and the two of us sit in the corner making small talk about the Atlanta traffic. There's nothing for Erik to do but stare at the wall and listen and wait.